Neonatal Anatomy Flashcards
What is the primary determinant of systolic BP in the neonate?
Heart rate
What is the formula to determine hypotension in a child older than 1 year?
Hypotension = SBP < 70 + (childs age in years x 2)
Infant larynx is located at C_ -C_ while the adult is located where?
C3-C4;
C5-C6
In the adult, the right bromchis takes off at __ degrees and the left at __ degrees from midline. How rose s the pediatric airway differ?
Right = 25 degrees
Left = 45 degrees
Up to the age of 3, both bronchi take off at 55 degrees from midline
Neonatal oxygen consumption vs adult
6-9 mL/kg/min (neonate)
3.5 mL/kg/min (adult)
Neonatal alveolar ventilation
130 mL/kg/min
Infants less than ___ weeks PCA should be admitted for 24 hr observation with an apnea monitor following anesthesia
60
What can reduce the risk of postop apnea after general anesthesia, but does not take the place of admission
Prophylactic caffeine (10mg/kg IV)
What is the primary muscle of inspiration
The diaphragm
What 2 types of muscle fibers make up the diaphragmatic and intercostal muscles?
Type 1 slow-twitch (built for endurance)
Type 2 fast-twitch (built for short bursts of heavy work)
In the neonate, what percentage of respiratory muscles are type-1 fibers?
25% (compared to 55% in adults)
Adult hgb consists of 2 ____ & 2 ___ chains while fetal hgb consists of 2 ___ & 2 ___ chains.
Adult: 2 alpha & 2 beta
Fetal: 2 alpha & 2 gamma
When does HgbA start to replace HgbF? When is it complete?
2 months; 6 months
What is the P50 of fetal hgb? Adult?
Fetal= 19mmHg
Adult= 26.5mmHg
TBW for premature infant
80-90%
When do signs of hypoglycemia manifest in the newborn?
< 72hrs old: < 30-40 mg/dL
> 72hrs old: < 40 mg/dL
Tx for hypoglycemia? If seizures present?
IV 10% dextrose 2mL/kg.
Seizures: 4mL/kg
After bolus D10 infusion at 8mg/kg/min
What year is normal GFR achieved? Tubular function?
GFR: 8-24 months
Tubular: 2yrs
CO of newborn
200ml/kg/min
Should the does of water soluble drug increase or decrease for a neonate?
Increase. Neonates have greater % TBW, so they require higher doses of water soluble drugs to achieve a given plasma concentration
What is the MAC of Sevo in a 3 month old?
3.2% (0-6months)
Why are neonates more sensitive to sedative-hypnotics?
Immature BBB
IM dose of succ for neonates/infants? Older children?
Neonates/infants: 5mg/kg
Older children: 4mg/kg
Only NDNMB that can be given IM. Dose <1yr? >1yr?
Roc
1mg/kg IM < 1yr
1.8mg/kg IM > 1yr
In a neonate with CDH, PIP should be kept below?
PIP < 25-30 cmH2O
After diagnosis, how long is CDH repair normally delayed?
5-15 days
List 3 physiologic conditions to avoid in a neonate with CDH
Hypoxia, acidosis, hypothermia
Causes by failure of the gut migration from the yolk sac into the abdomen
Omphalocele
Caused by occlusion of the omphalomesenteric artery during gestation
Gastroschesis
In the pt with pyloric stenosis, severe dehydration should be treated with a bolus of?
20 mL/kg 0.9%NaCl
NEC affects which area of the bowel?
Terminal ileum and proximal colon
